The Relationship Between the Activities-Specific Balance Confidence Scale and Balance Performance, Self-Perceived Handicap, and Fall Status in Patients With Peripheral Dizziness or Imbalance

Nolan Herssens, Eva Swinnen, Bieke Dobbels, Paul Van de Heyning, Vincent Van Rompaey, Ann Hallemans, Luc Vereeck

Research output: Contribution to journalArticle


Objective: Describe the relationship between the Activities-Specific Balance Confidence (ABC) scale and Dizziness Handicap Inventory (DHI) with balance performance, as well as fall status in patients with peripheral vestibular disorders.

Study design: Retrospective.

Setting: Outpatient balance clinic, tertiary referral center.

Patients: Data from 97 patients (age: 54.8 ± 12.3 yrs; 48 women) with dizziness or imbalance symptoms of peripheral vestibular origin were used for analysis.

Interventions: /.

Main outcome measures: ABC-scores, DHI-scores, static and dynamic balance tests, and fall status of the past 4 weeks, 2 months, and 6 months before the time of measurement were collected. Spearman's rho correlations, χ2 with post-hoc testing, and Kruskal-Wallis with post-hoc Mann-Whitney U test results were interpreted.

Results: The ABC- and DHI-scores show moderate correlations with static balance (ABC: r = 0.44; DHI: r = -0.34) and dynamic balance tests (ABC: r = [-0.47;0.56]; DHI: r = [-0.48;0.39]) and a strong inverse correlation with each other (ABC: 70 ± 25; DHI: 33 ± 26; r = -0.84). Related to fall status, weak correlations were found (ABC: r = [-0.29;-0.21]; DHI: r = [0.29;0.33]). Additional results show that subjects in the low-level functioning (ABC) or severe self-perceived disability (DHI) categories have a poorer balance assessed by standing balance, Timed-Up-and-Go and Functional Gait Assessment and are more likely to have experienced multiple falls.

Conclusions: The ABC-scale and DHI showed a strong convergent validity, additionally the ABC-scale showed a better concurrent validity with balance performances and the DHI with fall history. In general, patients with peripheral vestibular impairments reporting a lower self-confidence or a more severe self-perceived disability show worse balance performances and a higher fall incidence.
Original languageEnglish
Pages (from-to)1058-1066
Number of pages9
JournalOtology & Neurotology
Issue number7
Publication statusPublished - 14 Apr 2021

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